Over the past two-plus years, the Food and Drug Administration has approved multiple new treatments for hepatitis C virus (HCV) that offer nearly universal cure rates with minimal side effects. It is a remarkable success story for medical science. Unfortunately, many insurers – both private and public – are delaying access to new HCV treatments to patients until their disease has progressed and the liver is further damaged. There is no medical evidence to justify that position and much to justify treating all patients.
AASLD endorses treating patients with HCV as the standard of care. In the regularly revised HCV Practice Guidance of AASLD and Infectious Diseases Society of America we recommend early treatment of chronic HCV infection before the development of severe liver disease and other complications to improve overall survival rates. Studies demonstrate that new treatments cure more than 99 percent of patients followed for five years.
HCV treatment that leads to a cure is the only evidence-based intervention to prevent liver disease progression. A significant proportion of people living with HCV who have no or mild fibrosis (commonly described as F0-F2) will progress to cirrhosis in the absence of treatment. Currently, there is no way to predict who will develop advanced liver disease.
Inaction is harmful to patients. Untreated HCV has been linked to many causes of death, such as liver cancer and kidney problems. Delaying treatment for patients until they develop advanced liver disease leads to higher costs and higher demand for liver transplants. Patients who are unable to obtain curative treatment are at high risk for anxiety, illness uncertainty (the inability to determine the meaning of illness-related events), and depression, regardless of fibrosis stage. Patients who are cured of HCV report a significant improvement in their mental well-being.
Failure to treat leads to other medical problems. Among them are HCV-associated heart disease, lymphatic cancers, particularly non–Hodgkin Lymphoma, kidney damage in many patients and evidence of immune related disease when tested for rheumatoid factors. Studies show that HCV infection increases the risk of insulin resistance and diabetes by almost four times. Diabetes increases the risk of liver cancer in people living with HCV.
Access to curative therapies is the most effective way to eliminate the virus at a population level. The Department of Health and Human Services has cited an "emerging epidemic of HCV infection among young persons who inject drugs." Providing treatment to injection drug users is crucial to reducing the HCV burden within networks and preventing new transmissions. In addition, curing HCV is the best way to guarantee that women of childbearing potential do not transmit the virus to their developing fetus if they become pregnant.
AASLD is the leading medical organization for advancing the science and practice of hepatology. Founded by physicians in 1950, AASLD's vision is to prevent and cure liver diseases. This year's Liver Meeting®, held in San Francisco, CA, November 14-17, will bring together more than 9,000 researchers from 55 countries.
Media Contact: Gregory Bologna
The Liver Meeting® Press Room: November 13 – 17, 2015
Moscone West Convention Center, San Francisco, CA
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SOURCE American Association for the Study of Liver Diseases (AASLD)